Browse the corpus

Emergency medical services (EMS) are an essential healthcare component in the United States. EMS provides skilled acute care and timely access to definitive care for critically ill or injured patients. Situations like epidemics may overwhelm a medical facility's capabilities, affecting patient care quality or availability. EMS diversion occurs when emergency departments (EDs) temporarily close to incoming ambulance traffic.[1] When an ED assumes a diversion status, EMS must bypass that hospital and proceed to the closest facility with availability. Diversion may affect all ambulance traffic or limit admissions to certain patient types, such as trauma services, OB care, or advanced cardiac care.[2] Closing the doors to incoming EMS traffic allows facilities (sometimes regions) to focus on managing time-sensitive conditions. Though the premise seems reasonable, diversion's effects are now being questioned as “antithetical,” sparking controversy. Some cite diversion's ability to decompress a department as beneficial, while others condemn it as a fruitless and potentially harmful practice.[3] EMS diversion was initially intended to combat the growing issue of ED crowding. Facilities previously experienced rising ED wait times due to increasing patient volume. The perceived solution to this problem was to disperse incoming volume to less crowded facilities. However, EMS diversion has been shown recently to not only perpetuate the ED crowding issue but also to incite new problems. Understanding the difficulties, initiatives, and proposed plans to tackle EMS diversion and its effects on healthcare is crucial for safeguarding patient safety, optimizing resource allocation, enhancing system efficiency, protecting public health, informing policy and planning decisions, managing costs, and maintaining care standards within healthcare systems.